Individual
RONALD MORTON SHAFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3461 BRIDLEWOOD LANE, TERRE HAUTE, IN 47802
(812) 243-1590
(812) 234-6614
Mailing address
3461 BRIDLEWOOD LANE, TERRE HAUTE, IN 47802
(812) 243-1590
(812) 234-6614
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
01048560
IN
2084P0800X
Psychiatry Physician
Primary
01062324A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000481852
BCBS
IN
05
—
200828520A
—
IN
Enumeration date
06/14/2006
Last updated
01/04/2012
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